This proposal seeks to evalute recently introduced elements of prenatal care, presumed to be effective in reducing the incidence of preterm deliveries. The new elements currently on trial at the Harlem Hospital Center in New York City include: a more intensive schedule of clinic visits including follow-up of missed appointments; 24-hour personalized access to staff; repeated cervical examinations; additional social work support; and continuity of service personnel. In addition, a patient education program, focused specifically on the early recognition of contractions and the actions appropriate to these perceptions, is provided for a random half of women. All those receiving the new form of prenatal care are defined as high risk for preterm delivery (prior preterm delivery or late fetal death, or less than 17 or greater than 35 years of age). Neither the general new program nor the additional part may in fact be effective, and on the face of it the programs will add to the costs of the prenatal service while also inconveniencing the women concerned. Therefore, this proposal seeks, by usng available records, to carry out a comparison of historical controls with those currently enrolled in the new programs. A cohort will be created of a comparable high risk series of women who used the prenatal services of Harlem Hospital in the two years preceding the initiation of the new programs. The historical comparison will examine preterm delivery outcome in the first place. It will also compare birthweight, Apgar scores, number of clinic visits, the procedures and treatments noted, and the number and type of prenatal and perinatal hospitalizations.